Provider First Line Business Practice Location Address:
US HWY 290
Provider Second Line Business Practice Location Address:
CAMPBELL DRUG BLDG
Provider Business Practice Location Address City Name:
MCKEE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40447-0757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-287-5162
Provider Business Practice Location Address Fax Number:
606-287-8034
Provider Enumeration Date:
03/23/2006